Nicotine dependence in the mental disorders, relationship with clinical indicators, and the meaning for the user

Abstract

OBJECTIVE: to identify the degree of nicotine dependence among patients with schizophrenia and other mental disorders hospitalized in a general hospital, correlating these indices with clinical indicators and the meaning for the user. METHOD: the study was performed in the psychiatric unit of a general hospital, interviewing 270 patients with mental disorders using a questionnaire and the application of the Fagerstrom test. A descriptive statistical analysis of the data and thematic analysis of the content were performed. RESULTS: among the 270 patients with mental disorders, 35.6% were smokers; of whom, 53.2% presented high or very high nicotine dependence. Of the 96 smokers, 32 (33.3%) were schizophrenic, among whom, 59.4% presented high or very high dependence. Higher levels of dependence were also found among the 59 elderly people (61.5%) and 60 subjects with somatic comorbidities (62.5%). Meanings of smoking for the subjects: helps to forget problems and face daily conflicts; alleviates side effects of the medications; self-control; distraction; part of life. CONCLUSION: more intense tobacco dependence among schizophrenic patients is justified due to it helping them to cope with the difficulties of the disease. Nurses occupy a strategic position in the care.

Uso de tabaco em mulheres acompanhadas em um centro de atenção psicossocial

“…(15,16) Studies on tobacco use among Brazilian psychiatric populations yielded different prevalences: 21.4%, 35.6% and 52.7%, depending on the universe and mental disorder being studied. (8,17,18) High tobacco consumption affects the financial lives of people with mental disorders, since they allocate up to 30% of their monthly income on cigarettes; allocating more than 4% is already considered harmful. Difficulty in obtaining cigarettes leads some individuals with mental disorders to humiliating practices, such as stealing and smoking cigarette butts, which undermines their self-esteem and self-respect.…”

Nicotine dependence in resistant schizophrenia: A compensation for trihexyphenidyl dependence or just comorbidity

“…There was a dependence on nicotine and trihexyphenidyl. The dependence on nicotine in schizophrenic patients can be explained through several mechanisms: • Regular use of nicotine leading to dependence (as seen in individuals without any other psychiatric disorders) [1] • Increased use of nicotine to compensate for the negative, cognitive, and depressive symptoms of schizophrenia [1,3,4] • Nicotine use also reduced psychotropic drug-induced side effects [1,4] • As a reinforcement measure [3] • Impaired judgment due to schizophrenia, leading to unrestrained use of nicotine [1] • To compensate for the antipsychotic induced dopaminergic blockade at the reward pathway [4][5][6] • To compensate for the cholinergic deficiency (anticholinergic effects) due to trihexyphenidyl dependence.…”

“…[1][2][3] It is away patients deal with the illness-related difficulties. [1] The exact cause that links nicotine dependence as comorbidity with schizophrenia is uncertain.…”

“…[1][2][3] It is away patients deal with the illness-related difficulties. [1] The exact cause that links nicotine dependence as comorbidity with schizophrenia is uncertain. [3] Nicotine is a known inducer of liver cytochrome P450 enzyme system, through which most psychotropic medications are metabolized.…”

Cigarette Consumption and Related Factors in Schizophrenia, Schizoaffective Disorder and Delusional Disorder

“…Smoking may be also a way of coping with boredom and loneliness resulting from deterioration of social and occupational functioning (3). Most frequently reported factors by smokers, as the cause of smoking are: it is stimulating or calming/ relaxing; it helps to forget about problems, to cope with everyday problems; its socializing effect; and addiction (4,5). Patients with schizophrenia have also stated that the most common cause of smoking are its pleasing and anxiety relieving effects (6).…”